血清CA125及LDH在子宫肉瘤妇女中的检测价值分析

Analysis of the value of serum CA125 and LDH in women with uterine sarcoma

目的分析血清糖类抗原125(CA125)及乳酸脱氢酶(LDH)在子宫肉瘤妇女中的检测价值。方法回顾性分析2016年12月至2018年12月期间杭州市西溪医院收治的98例子宫肉瘤患者的临床资料,分析子宫肉瘤患者的首发临床表现,并分析同期该院收治的98例子宫平滑肌瘤患者的临床资料,比较子宫肉瘤与子宫平滑肌瘤患者的血清CA125及LDH水平,探讨两者在子宫肉瘤妇女中的检测价值。结果 98例子宫肉瘤患者中包括子宫平滑肌肉瘤(LMS)41例,子宫内膜间质肉瘤(ESS)37例,未分化子宫肉瘤(UUS)20例,子宫肉瘤患者的首发临床表现主要为阴道出血(52.05%)、阴道排液(16.33%)、腹部包块(12.24%)。子宫肉瘤患者的血清CA125、LDH-A、LDH-B、LDH-C、LDH-D、LDH水平均显著高于子宫平滑肌瘤患者(t值分别为2.084、2.559、2.489、2.549、1.975、2.767,均P<0.05)。LDH对于子宫肉瘤的预测价值高于CA125,两者AUC分别为0.757、0.546。当血清CA125临界值为21.67U/mL时,诊断的特异度为62.10%,敏感度为55.00%。当血清LDH临界值为199U/L时,诊断的特异度为96.40%,敏感度为61.90%。结论子宫肉瘤患者的首发临床表现以阴道贫血、阴道排液、腹部包块为主,LDH对于子宫肉瘤的预测价值高于CA125。

Objective To analyze the value of serum carbohydrate antigen 125(CA125)and lactate dehydrogenase(LDH)in women with uterine sarcoma.Methods The clinical data of 98 patients with uterine sarcoma admitted to Xixi Hospital in Hangzhou city during the period from December 2016 to December 2018 were retrospectively analyzed and the clinical data of 98 patients with uterine leiomyoma admitted to our hospital were also retrospectively analyzed.To analyze the first clinical manifestations of patients with uterine sarcoma,compared the serum CA125 and LDH levels of patients with uterine sarcoma and uterine leiomyoma,and to analyze the detection value of serum CA125 and LDH in women with uterine sarcoma.Results Among the 98 patients with uterine sarcoma,41 cases had LMS,37 had ESS and 20 had UUS.The first clinical manifestations of patients with uterine sarcoma were mainly vaginal bleeding(52.05%),vaginal drainage(16.33%)and abdominal mass(12.24%).Serum levels of CA125,LDH-A,LDH-B,LDH-C,LDH-D and LDH in patients with uterine sarcoma were significantly higher than those in patients with uterine leiomyoma(t value was 2.084,2.559,2.489,2.549,1.975,2.767 respectively,P<0.05).The predictive value of LDH for uterine sarcoma was higher than that of CA125,and their AUS value was of 0.757 and 0.546 respectively.When the critical value was 21.67 U/ml,the specificity of serum CA125 diagnosis was 62.10%and the sensitivity was 55.00%.When the critical value was 199 U/L,the specificity and sensitivity of serum LDH diagnosis were 96.40%and 61.90%respectively.Conclusion The first clinical manifestations of uterine sarcoma patients are vaginal anemia,vaginal discharge,abdominal mass,and LDH has a higher predictive value for uterine sarcoma than does CA125.